This application proposes development of MedMate, a unique adherence enhancement system designed especially for patients on HIV/AIDS medication. While newly developed protease inhibitors significantly reduce viral loads, these medicines require high levels of adherence with exceedingly complex regimens. Non-adherent patients risk developing resistant HIV strains. The MedMate system will utilize advanced computer and communication technologies to produce a handheld comprehensive, user-friendly product for HIV/AIDS patients to help them cope with taking these medicines. The MedMate system will also have enormous value as a research tool. Based on the empirical literature, MedMate will contain educational, affective, and behavioral components designed to enhance adherence. MedMate helps plan a safe, optimized regimen tailored to the patient's lifestyle, serves as a patient reminder system, addresses problems of missed medications, changes in schedules/time zones, etc., monitors severity of side effects, and permits customized adherence feedback. Phase I was successfully completed. Phase II will see the final production of MedMate components, including videotapes for patients and providers, a System User Brochure, specialized software for use with a Personal Digital Assistant (PDA), and software for a centralized server which houses the database and communicates with the PDA via a wireless or modem connection. A comprehensive field trial will follow 1 56 patients for nine months to test the effectiveness of the MedMate system. PROPOSED COMMERCIAL APPLICATION: ITS will work with RXI, a national prescription benefits management company, to develop commercial relationships with pharmaceutical companies, pharmacies, and provider organizations. ITS/RXI plans to develop a varied revenue stream that would include a referral fee when patients or providers use the MedMate system to purchase prescriptions from commercial pharmacies, as well as nominal provider or patient subscription fees for use of the software and database. Given the size of the HIV/AIDS therapeutic market, which is estimated to reach $3.8 billion in the year 2000 and $8.2 billion by 2005, as well as the hundreds of million dollars spent on HIV/AIDS related research, the commercial impact of this project is extremely promising.